Living with hope through chronic illness

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A Letter to Doctors

Doctor Visit (Photo credit: Forty Two.)

This letter has been on my mind and my heart for over ten years now. It is not an easy letter to write, and it may not be an easy letter for doctors to read, but I hope it’s an encouragement for all who do read it.

I’m grateful for the men and women who have chosen the grueling and difficult path of medical school, followed by several years of residency and internship to become physicians. The many doctors who have spent years researching diseases and chronic illnesses, and who have developed successful treatments have my admiration and thanks for their passion and their determination. I’m certainly indebted to the many doctors who rise early to do hospital rounds, who see patients and/or perform surgery during the day, who return phone calls or review patient records at night, and who often sacrifice time with their families to bring health to our lives.

Our family has four people who have been diagnosed with chronic illnesses and over a 25-year period, we have seen hundreds of doctors in several states for diagnoses, second opinions, treatments, procedures and tests. We have seen the “good, the bad, and the ugly.”

This article contains no statistics, no results from double-blind studies, no comparison of the effectiveness of medical treatments, and no information from clinical trials. It does contain the observations of a patient, wife, and mother and her experiences with and perspective on our family’s encounters with the medical community. If you looked at our calendar the last few years, you’d see our family has had an average of 60 visits to doctors each year, not including visits for laboratory tests or procedures.

When our children lived under our roof full-time, I was the family manager of four people’s doctor’s appointments, medications, and treatment regimens. In 1982, I was diagnosed with Ulcerative Colitis; I also was diagnosed with endometriosis several years later, which required several laparoscopies and medication for treatment, and most recently, a robotic-assisted hysterectomy. Approximately four years ago, I was diagnosed with Late Stage Lyme Disease, which is very controversial. I have had several procedures to remove kidney stones and to open more fully my urinary tract, and I have hypothyroidism.

My husband of 32 years was diagnosed with Chronic Fatigue Immune Dysfunction Syndrome (CFIDS), officially in 1990, and we had to travel to the Cleveland Clinic to get that diagnosis and a treatment plan. Our 22-year old son was diagnosed with Crohn’s Disease in 1996 at the young age of seven at Penn State Hershey Medical Center. Our 25-year old daughter was diagnosed with Crohn’s Disease in 2006 in her sophomore year of college. There are very few lab tests, procedures, diets, food regimens, and alternative therapies that our family has not tried.

We are a family who have always been active physically and have maintained relatively healthy diets and lifestyles. When I met my husband, he was an avid racquetball player; he then became an avid runner and now does cardio workouts and strength training at a local fitness center at least five times per week. I have been a group fitness instructor for over 25 years and am certified as a personal trainer. We are not a family that is careless about our eating habits, and many of our doctors have attributed our ability to stay active in our work and other activities to our healthy lifestyle.

Treating a patient with a chronic illness that has no cure can be a frustrating experience for doctors, and is often the most difficult patient to care for. Most doctors only see the patient 10-15 minutes every four to six months. Unless there’s a new medication or treatment that has been developed or the patient has had some change in symptoms, doctors often feel they have little to offer, and the patient lives in the status quo. There can be a feeling of frustration, defeat, and helplessness on both sides.

There are several who have treated us who have been able to compassionately overcome this dilemma, providing encouragement and understanding in the midst of chaos.

There’s the obstetrician/gynecologist who delivered both of our children (and continues to treat me today) who always considers not just my health status, but the health status of our whole family before prescribing any treatments or going forward with any procedures. He treats the whole person, physically, mentally, and emotionally.

There’s the infectious disease doctor we found after we returned from the Cleveland Clinic who willingly and passionately treated patients with HIV, CFIDS, SAD (Seasonal Affect Disorder) and other chronic and sometimes fatal diseases, who was ALWAYS on time with his appointments, and who did not “write off” new symptoms of the disease he was currently treating. He was willing to turn over every stone to find a way to bring more health and wholeness to his patients. When this doctor retired from his practice, he referred my husband to a young doctor, who, although he didn’t know as much about CFIDS or infectious disease, was teachable, humble, and willing to learn through resources my husband offered him. He also cared as much about being a good husband, father, and man of character as he did about being a good doctor.

There’s the very knowledgeable, kind, and caring pediatric gastroenterologist who diagnosed our son’s Crohn’s Disease (at age 7) with much anguish, and explained his treatment thoughts and plans in detail, not only to us as the parents, but also to our son. As our son moved into adolescence, this doctor was also able to provide a safe and comfortable environment for a teenage boy to talk about his symptoms, for a disease that is often very embarrassing to talk about.

There’s the very impassioned family doctor who we found about seven years ago who treated and walked alongside me eight years ago, when I was diagnosed with clinical depression, and whose knowledge, treatment, and compassion proved to be a much greater blessing than more specialized approaches. She listens to her patients and trusts that they know their bodies better than she does, and then she responds with appropriate action and concern. She’s not afraid to try other approaches when recommended treatments are not effective. For example, she was very supportive of the controversial treatment I received for my Late Stage Lyme Disease (from an infectious disease specialist), primarily because my health improved as a result of the treatments.

These are a few of the “gems” we have uncovered in our medical journey and our lives are better in many ways, even if not physically, for our interaction with them. I’ve been giving a lot of thought to what makes these “gems” shine.

First, they not only have a passion for medicine and their specific discipline, but they also have a passion for learning about and knowing their patients. They listen, I mean they really listen, when a patient describes symptoms, reactions to medications, or how they are feeling overall. And when they listen, they also discern or search out the fears, concerns, anxieties, and worries that lie behind what their patients have verbally and visually conveyed. And then they go one step further and take this information into consideration before considering or discussing any treatment regimens.

Second, these “gems” talk to patients at the patients’ intellectual level. They don’t talk in medical language that is too difficult to understand, or in a tone that is condescending. Nor do they make their explanations too simple or condensed that they gloss over important information that patients need to know. If they have to explain a complicated medical situation or procedure, they do so with aids that help visualize what is happening/will happen and with words that explain how the procedure will be beneficial or how the situation is affecting the body. These doctors allow time for questions and concerns.

Third, all of these doctors had or wanted strong family relationships, and talked about their families or asked about my family at most visits. Because the treatment of a medical condition can change the dynamics in a family, these physicians take into consideration how a medical diagnosis and its short and long-term treatment may affect each family member. Before prescribing treatment, my gynecologist will always check to see how our other family members are doing, what other medical issues I may be dealing with, and how much time I will have to be absent from work and other activities. By inquiring of these other aspects of a patient’s life, a physician can gain insight into the level of treatment a patient can tolerate, and can allow the patient to actively participate in that treatment plan.

Fourth, when a patient calls into these physicians’ offices with a question or a concern, someone in the physician’s office returns the call within a reasonable amount of time, usually the same day. When necessary, the physician will speak to the patient personally to explain in greater detail, allay any concerns or fears, or encourage the patient. In addition to the initial response, these physicians also have consistent follow up, either personally or through their staff, when necessary.

Finally, my husband’s and my faith in God is of primary importance in our lives, and we believe that faith has given us the strength, courage, patience, and endurance needed to survive and even to be strengthened during the last 25+ years with our chronic health issues. These “gems” have either shared and expressed that faith or acknowledged and admired its significance in our lives. To one of these doctors who walked alongside us through a difficult and uncertain time, I gave a framed certificate that said, “Find a doctor who believes that God is greater than the medical profession and you have found a rare gem.”

All of these doctors indicated that they learn much more about life, what’s important in life, and how to handle adversity and chronic pain and illness from their patients who have endured…who have “fought the good fight”……who have “kept their eyes on the prize”…..and their lives are richer for the lessons they have learned.

So the next time you have an appointment with a “gem” of a doctor, don’t forget to tell him or her how special they are to you, not just for their medical treatment, but for looking at you as a “whole person,” not just as a disease or illness. And that “gem” of a doctor might just “shine” for other patients, too!